Surgery is a skilled speciality within medicine that should only be carried out in a medical facility by a specialist doctor or surgeon. All surgical procedures carry a very low risk of infection, scarring and other possible wound healing problems. Dr Jhetam will give you an honest professional opinion as to whether undertaking the surgical route is the best option and may discuss alternative choices if appropriate before proceeding.
Moles, skin tags, warts and cyst removal are the commonest reasons why surgery is required with the shave excision being the most popular for cosmetic moles and the ellipse excisions for more difficult or darker moles. All our patients have pre-operative consultation and are fully informed of the risks and expected results of the procedure prior to signing a consent form.
At SkinMedics we favour the least invasive approach to surgery as possible to achieve the highest possible satisfaction. We are also fortunate to have premises where we can 'see and treat' patients on the same day.
All surgical treatments require a local anaesthetic which is an injection administered into the skin just numbing the area that needs to be treated.
Local anaesthetic is a pharmacological agent that is injected either into the immediate area that is to be treated, so only numbing a tiny area or can be used in a regional block which involves numbing a larger area. The area will be completely painless afterwards.
There are various types of anaesthetic with different strengths and duration of action. In minor surgery it is common place to use lignocaine with adrenaline as this helps minimise any bleeding during the surgery. Very rarely people can feel their heart race or feel a bit faint which passes in a few minutes. This used frequently by dentists so if you have not had a reaction when a having any tooth treatments then you are unlikely to have any issues. Again this is why is it important to have a thorough medical consultation and any local anaesthetic injected in a medical setting.
Anaesthetic injections are also available without adrenaline and are used for surgery on the fingers and toes as well as for anyone who is sensitive to adrenaline. Most anaesthetics work within 1-2 minutes and last for 1-3 hours.
Anaesthetic creams such as EMLA are also available for less invasive skin treatments and provide a good numbing effect.
Shave excisions are the easiest and commonest form of mole removal for moles that protrude from the skin. They involve a tiny painless injection of local anaesthetic just under the mole to numb just that part of the skin. A special dermablade is then used plane down the mole or lesion so it is flat on the skin.
It only takes a few minutes to perform and no stitches are required. It takes only a 7-10 days to heal and only leaves a tiny mark. Most patients cannot believe how quick and easy it is and often wished they had done it sooner. If the moles are in any way worrying we would perform an ellipse excision surgical procedure.
Ellipse Excision Surgery
Moles that are flat, potentially worrying or not suitable for shave excision or laser treatments require ellipse excisions. These involve a small painless injection under the mole only to numb just that area. With precision cutting the entire mole is removed in one go. The remaining opening is then brought together with skin stitches that in most cases just simply dissolve away. The result is a thin white line instead of the mole. This only takes about 20 minutes and is not painful.
Usually a dressing is placed over the wound to protect it for the first week and then moisturing and massaging the wound to help improve the scar with vitamin e, bio-oil or silicon gels is advised. The wound initially starts of red and then gradually fades to a whitish line. Very rarely scars can overheal and form keloid or hypertrophic scars which would then require further treatment.
WARTS & SKIN TAGS
Warts and skin tags are incredibly common, but they can be very embarrassing and annoying when they do not disappear, are resistant to treatment, or are in an awkward or obvious place. However skin tags and warts are relatively easy to get rid of with simple removal procedures available at SkinMedics. Finger and hand warts are the commonest sites for treatment, as well as the face and genital area. Neck, groin and eyelid tags also get excellent results.
Professional wart and skin tag removal is extremely effective. There are 3 options used depending on the problem.
1. Cryotherapy / Freezing
For small warts and skin tags, freezing is the simplest and best method of removal. This usually involves applying some liquid nitrogen spray onto the lesion which then blisters for a few days before scabbing and falling off. With resistant warts sometimes a daily regime of paring down (with emery board), then applying Occulsal cream to burn off the wart and then wrapping in tape is also required.
2. Surgery (minor)
Minor surgery is also a common option for skin tags. They can sometimes be numerous in number and in delicate areas that freezing skin tags may not be ideal for. The procedure is normally done with some anaesthetic so no pain is felt and is very simple and quick to do by simply snipping them off and cauterizing the base to stop recurrence.
3. Laser wart removal and wart removal surgery
This option is used for resistant warts that have failed to respond to all other methods and used specifically for thick larger warts. It involves an injection to numb the warty area and then the whole wart is literally burned off leaving a wound that will take 1-2 weeks to heal.
Specialised treatments for keloids are offered. A treatment plan involving injection of keloids is used for small keloids. Larger and complicated keloids are treated with surgical excision and post-op radiotherapy or injections.